Cavex Bite&White Patient Kit

Discoloration of the teeth can have an intrinsic and/or an extrinsic cause. When the discoloration has an intrinsic cause, it means that there are small cracks in the enamel and dentin. Molecules within these cracks discolor, and that is what can be seen. Extrinsic means “from the outside” and these are the stains on the surface of the teeth.
The gel that is being used for Cavex Bite&White contains 16% carbamide peroxide. This proven whitening agent is able to penetrate enamel and break down the discolored molecules through the formation of radicals (small energy balls).
For the stains on the outside “extrinsic” part of the teeth, sometimes a whitening toothpaste would suffice. Using a direct whitening gel however would handle both intrinsic and extrinsic stains, being more thorough and therefore more effective.

Whitening should only be done under a dentist’s supervision. Tooth‐whitening under controlled dental office conditions is safe and effective. Clinical studies support the safety and effectiveness of home‐use bleaching gels when used appropriately. Tooth sensitivity and irritation to soft tissues can occur during bleaching treatment, but these effects only last for a short time. Cavex Bite&White has been developed and produced according strict European Cosmetic legislation and has undergone thorough testing and evaluation.

In short, at the dentist and the dentist via a dental distributor. Cavex Bite&White should only be sold by a dentist. Before any whitening procedure, a consultation with a qualified dentist is recommended to ensure no underlying oral or health issues. According to the new European Cosmetic Directive 76/768/EEC, tooth whitening or bleaching products containing between 0.1 % and 6 % hydrogen peroxide (16% carbamide peroxide) can only be sold by dentists. Higher concentrations are not allowed to be sold within Europe.
The purpose of the law is twofold. On one hand, it is designed to reduce the risk of damage to tooth and gums that could result from the use of a tooth whitening product releasing more than 6% hydrogen peroxide. The law also intends to ensure that all tooth whitening procedures, performed with a significant amount of hydrogen peroxide released, are overseen by someone with the training and knowledge required to make sure the treatment is carried out safely and effectively. Cavex Bite&White is developed in full compliance with this new European legislation, and Cavex fully supports the enforcement of this law.

With Cavex Bite&White we recommend to whiten the teeth one‐and‐a‐half hour before sleeping Brush the teeth, put the bleach trays in, leave them in for 1 hour, rinse the mouth, wait 20 minutes, gently brush with fluoride tooth paste, sleep well.
While sleeping there is sufficient time for re‐mineralization after bleaching. It takes some time for the teeth to regain their initial strength.
Right after bleaching, your teeth are more sensitive to discoloration by foods or drinks. The structure of the teeth is “open”, so eating or drinking products (red wine, coffee, tea, soda, smoking…) that could stain are advised against. Anything that can stain a white t‐shirt can stain your teeth. While sleeping you don’t eat or drink, so there is no risk of staining.

We advise to keep the tray in the mouth for one hour. The “active ingredient”, in the case of Bite&White is carbamide peroxide, needs about one hour to take full effect.

In the starter kit there are 2 syringes with gel. Both syringes should have enough material for 5 days, so 10 days period of whitening (upper and lower jaw) in total. If by this time the patient have reached his/her goal, great. If not, discuss possible prolongation of the treatment.

The well fitted tray, combined with the thixotropic whitening gel should ensure that the gel will not be in contact with the area’s which are sensitive for irritation like your gums. Cavex Bite&White contains potassium nitrate in the gel. This is a desensitizer, therefore minimizing sensitivity. Slight sensitivity is possible and differs from person to person. In this case a desensitizer like Cavex ExSense could help.

We honestly cannot guarantee an exact indication except.. teeth will get whiter! The amount of shades lighter differs too much from person to person. It all depends on the nature and current state of the teeth, the type of measurements and the motivation(discipline) of the user. When the patient is not satisfied with the results after the 10 days of use, consult if it is possible to extend the treatment with an extra syringe of whitening gel.

Transportation of Cavex Bite&White products based on carbamide peroxide does not require a conditioned environment. The products can be transported dry and without direct sunlight, at a temperature of up to 25 ° C, without any negative effects.

Like all products, Cavex Bite&White also has its expiration date. Cavex Bite&White can be stored for at least 3 years, but only when stored in the refrigerator.

There are two ways to effectively whiten teeth. One is the “fast” in-office treatment at a dentist, the other way is at home.
Chair‐side is mostly done with a “high peroxide gel and a light* in the dentist office. After the session the patient’s teeth will have undergone some degree of whitening.
The process of a take home system is slightly different. There are two ways. The dentist will have to take an impression, which will be used for making a custom-made tray. The patient will receive this tray together with the Cavex Bite&White peroxide gel. The patient takes it home and applies the gel in the tray and mouth his/herself.

Always store the whitening gel in the refrigerator. This is because high temperatures cause activation of the peroxides in the gel, resulting in a less effective low concentrated gel.

Whiten the teeth while having restorations is possible, however, these restorations won’t be affected by the whitening gel. A solution to this is to replace restorations after reaching the desired color. Always make these decisions together with the dentist!

Whitening should be done only under dentist supervision. Tooth‐whitening under controlled dental office conditions is safe and effective. One main reason why many tooth whitening gels are dangerous for the teeth is the pH‐value. Many whitening materials have a low pH, and go with the saying “no pain, no gain”. Teeth generally become more sensitive than before using these materials and enamel weakens. Cavex Bite&White is pH‐neutral, and therefore safe to use.
Clinical studies support the safety and effectiveness of home‐use bleaching gels when pH‐neutral and used appropriately. Tooth sensitivity and irritation to soft tissues can occur during bleaching treatment, but these effects only last for a short period of time.

Yes, the gel used for the whitening treatment contains fluoride. Fluoride is a proven agent for early re‐mineralization and restoration of the micro‐hardness.

The claim of a lamp is that it accelerates the effect of the peroxide. However, literature does not prove the effectiveness of a lamp accelerated bleaching. High intensity of light could cause few degrees of temperature increase which result in faster decomposition of the peroxide. Numerous studies indicate that the faster the bleaching process the higher the reversal rate. Also, the heat from the light on your teeth for a long period of time is potentially dangerous to the pulp of the teeth. Cavex only believes in controlled and gradual whitening procedures with moderate peroxide amounts. These tend to have a low reversal rate, with significant less sensitivity and are gentle for the mouth and body, eliminating any risk.

Based upon numerous studies the Scientific Committee on Consumer Products (SCCP) made in 2011 a safety evaluation on the use of hydrogen peroxide in oral hygiene products and tooth whitening products. As in many risk evaluations the SCCP used the Margin Of Safety (MOS) to determine the maximum concentration which can be considered as safe. The MOS is the ratio between the NOAEL (No‐Adverse‐Effect‐Level) determined in animals and the level to which humans may be exposed.
MOS values below 100 have been interpreted by the regulatory bodies as not safe.
Margin Of Safety = NOAEL (mg / kg bodyweight / day)
Exposure (mg / kg bodyweight / day)

NOAEL for hydrogen peroxide:
A 100 days rat gavage study showed a significantly reduction of the plasma catalyst level at higher dosage. Based upon this study the NOAEL (No‐Adverse‐Effect‐Level) was stated at 20 mg/kg bw/day.
Estimated Daily Exposure (average 60 kg bodyweight):
Toothpaste = 480 mg/day containing 0.1% hydrogen peroxide
0.48 mg / 60 = 0.008 mg/kg bw/day MOS = 20/0.008 = 2500 = SAFE
Mouth‐rinses = 3000 mg/day containing 0.1% hydrogen peroxide
3 mg / 60 = 0.05 mg/kg bw/day MOS = 20/0.05 = 400 = SAFE
Tooth whitener = 200 mg gel / tray / day containing 6% hydrogen peroxide
12 mg / 60 = 0.2 mg/kg bw/day MOS = 20/0.2 = 100 = SAFE
Tooth whitener = 200 mg gel / tray / day containing 35% hydrogen peroxide
70 mg / 60 = 1.17 mg/kg bw/day MOS = 20/1.17 = 17 = NOT SAFE

Conclusion: Based upon the MOS evaluation the SCCP considered 6% hydrogen peroxide (16% Carbamide peroxide) to be the maximum allowed concentration.
References:
SCCP report 18/12/2007– on file

There are three things that could be going on.
1. Fluorosis. This is one of the reasons a whitening procedure is done under supervision of the dentist. A patient could have always had this but never noticed it before. Fluorosis is a developmental disturbance of dental enamel caused by excessive exposure to high concentrations of fluoride during tooth development, not by using whitening products.
2. The patient have had braces/brackets and started a whitening treatment right after removing them. The brackets have caused the enamel to decalcify, and these spots might be more sensitive. There are ways to remove the stains, but discuss this with the dentist.
3. The teeth are dehydrated. The patient have used a high‐peroxide gel for too long, and it dehydrated the teeth. Do not worry; these stains will clear after a few days. We call this the “Chicken bone‐effect”. Leave a chicken bone to dry for a couple of days and it will turn white. Put it in water and it will return to the original color. Chances of this happening with moderately dosed whitening gels, like Cavex Bite&White” are minimal.

When this occurs there are a few possible explanations.
1. The patient has a bracket wire in the mouth. The peroxide reacts to this metal and starts to foam. The dentist should check for this when providing the whitening material.
2. There is some sour fluids (acid) in the mouth. The peroxide reacts to sour fluids, so try avoiding this by rinsing well after using sour mouthwashes etc.